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Only one-third of Canadians will admit to being "very" or "somewhat" overweight, despite national statistics that indicate the true proportion of overweight Canadians is approaching double that.

In addition, nearly six out of 10 Canadian adults polled think they’re of “average” weight, according to a survey commissioned by the Canadian Medical Association. But average weight has been going up in Canada.

Experts say the survey highlights how society’s view of what’s considered “normal” body weight is changing. We think a bigger weight is normal, said Dr. Sean Wharton, an internal medicine specialist.

“Average probably means to them that they feel that they’re not in the overweight or obese category, but clearly most people are,” Wharton said.

“Many people are looking at their increased weight as not so much of a problem,” he said, when in fact blood tests and ultrasounds often reveal brewing health problems associated with overweight — including hypertension, diabetes and non-alcoholic fatty liver disease, the leading cause of liver failure in North America.

Many in the survey also said that the economic downturn has impacted their health. According to the report, one in four Canadians agree they have spent less time, energy and money maintaining their health because of the economy.

To be released Monday at the CMA’s annual general council meeting in Yellowknife, the poll found that lower-income Canadians are more likely to say they are overweight, peaking at 38 per cent among those with household incomes of less than $30,000 a year.

They also reported poorer health and greater use of health services than did those with higher incomes.

Only 39 per cent of those earning less than $30,000 a year described their health as excellent or very good, compared to 68 per cent of those earning $60,000 or more — a difference of 29 percentage points.

In 2009, the gap between the two groups was 17 points.

One in four low-income Canadians said they have put off or stopped buying prescription drugs; one in four said they have skipped meals because of financial worries.

The health gap between “the ‘haves’ and ‘have nots’ appears to be widening,” said Dr. John Haggie, out-going president of the 76,000-member CMA.

“I had a lady in her late 50s who used to take her diabetic medication every second day. She couldn’t afford a month’s supply, she’d make it last two months. Her (blood) sugars were crazy,” said Haggie, a general and vascular surgeon in Gander, N.L.

Health has emerged in recent polls as the top issue in the minds of Canadians, Haggie said. “So, really and honestly, if we’re looking at everything through the lens of economic development, why can’t we also look at it through the lens of health impact?”

The survey was released to coincide with the opening of the CMA’s general council meeting, the first time the annual gathering of delegates will take place in the Northwest Territories.

Between July 23 and July 30, Ipsos-Reid surveyed 1,004 Canadian adults online and another 1,200 by phone. With samples of this size, the results are considered accurate to within 3.2 and 2.8 percentage points respectively, plus or minus, 95 per cent of the time.

Overall, 58 per cent rated their health as either excellent or very good; about one in 10 rated their health as either fair or poor.

The poll found that Canadians are divided over whether health care will get better (36 per cent) or worse (48 per cent) over the next two or three years.

One in four say they have spent less time, energy and money on their health as a result of the economic downturn. Half (50 per cent) are worried about their health — more than are worried about financial security or losing their jobs. One in three say they feel stressed or overwhelmed by financial worries.

When it came to perceptions of being overweight, there was little variation across regions. Overall, 33 per cent of Canadians polled considered themselves to be very (four per cent) or somewhat (29 per cent) overweight.

According to Statistics Canada, 60 per cent — 7.6 million — of Canadian men and 44 per cent (5.6 million) of Canadian women were overweight or obese in 2011. But those figures are based on self-reported data, and relying on people to report correctly is a problem. People tend to underestimate their weight, and overestimate their height.

“We collectively as a nation don’t tell the truth on our driver’s licence,” said Dr. David Lau, professor of medicine at the University of Calgary. “We’re two inches taller and five pounds lighter.”

We use other people as our frame of reference, “so when you look around and everybody’s rotund, we don’t consider ourselves overweight, because we’re no different than our neighbour or the people we work with,” Lau said.

When asked to describe their children’s weight, just over one in ten Canadian parents (12 per cent) said their children are either very or somewhat overweight. B.C. parents were the most likely to describe their children as “overweight.” But B.C. parents are also most likely to decribe their eating habits as “well-balanced and healthy.”

Four in five (81 per cent) said their children are of average weight for their height and age.

According to Statistics Canada, 17 per cent of children in Canada are overweight; another nine per cent are obese.

Lau, an adult endocrinologist, sees one overweight teenager a week — boys in particular — with fatty liver. Once unheard of in children, the condition can lead to hepatitis, fibrosis, cirrhosis and liver failure.

“Teenagers who are overweight and obese are tracking all the adult problems years earlier,” Lau said, meaning overweight youth may have a shorter lifespan than their parents.

Lau recommends people strive for the best health possible, through regular physical activity and healthy eating. “For some people, this may be higher than ‘normal’ weight,” he said.

But half of those surveyed by Ipsos-Reid said it’s hard to find the energy (49 per cent) or time (52 per cent) to be active.

“If you’re struggling to hold two jobs — and they may be sedentary jobs, they may be minimum-wage jobs that aren’t physically very active — when you have to balance two jobs and family, you really don’t have time to put on a pair of sneakers and go for a jog,” Haggie said.

“You do what you have to do to survive, and your health gets neglected as a consequence.”

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Canadians are fatter than they'll admit: study

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